From the infant to the geriatric patient —Strategies for inhalation therapy in asthma and chronic obstructive pulmonary disease

Inhalation therapy is a highly individualized concept of therapy. Age, maturity and comorbidities have to be considered when choosing a specific inhalation device. Standardized algorithms may support this decision process. A close monitoring is essential as it may detect handling mistakes and the need to modify the device concept. A routine reevaluation of the inhalation concept should be implemented with age, maturation and new occurring comorbidities. AbstractInhalation therapy represents the standard of care in children, adolescents as well as in young, middle-aged and geriatric adults with asthma or chronic obstructive pulmonary disease. However, there are only few recommendations for the choice of inhalation devices, which consider both, age-specific limitations in young and geriatric patients. Transition concepts are lacking. In this narrative review, the available device technologies and the evidence for age-specific problems are discussed.Pressurized metered-dose inhalers may be favoured in patients who fulfill all cognitive, coordinative and manual power requirements. Breath-actuated metered-dose inhalers, soft-mist inhalers or the use of add-on devices such as spacers, face masks and valved holding chambers may be suitable for patients with mild to moderate impairments of these variables. In these cases, available resources of personal assistance by educated family members or caregivers should be used to allow metered-dose inhaler therapy. Dry powder inhalers may be...
Source: The Clinical Respiratory Journal - Category: Respiratory Medicine Authors: Tags: REVIEW ARTICLE Source Type: research